Arthrosynovektomie bei juveniler Arthritis

Zusammenfassung

Der Stellenwert der Synovektomie bei der juvenilen Arthritis ist bislang nicht hinreichend belegt. Die Indikation wird, analog zu den adulten Formen der rheumatoiden Arthritis, bei „therapiefraktärer“ Synovitis gesehen. Kleinere Fallserien legen den Schluss nahe, dass bei den meisten Patienten eine mittelfristige Verbesserung von klinischen Parametern (Schmerz, Beweglichkeit) erreicht werden kann, auch bei bereits vorhandener Gelenkschädigung. Eine enge interdisziplinäre Zusammenarbeit zwischen Kinderrheumatologie und orthopädischer Rheumatologie ist erforderlich, um die Indikation zur Synovektomie individuell und zeitgerecht zu stellen.

Summary

The utility of arthrosynovectomy in patients with juvenile arthritis has not been sufficiently evaluated so far. Treatment refractory synovitis represents, as in adult onset rheumatoid arthritis, the indication for synovectomy. There is some evidence that a medium-term improvement of clinical parameters, such as pain and functioning, can be achieved by synovectomy in the majority of JIA-patients, even in cases with pre-existing joint damage. A close interdisciplinary co-operation between paediatric rheumatologists and orthopaedic rheumatologists is necessary for a patient-oriented and timely decision regarding an arthrosynovectomy.

Schlüsselwörter

Juvenile idiopathische Arthritis - Synovektomie - arthroskopische Synovektomie

Keywords

Juvenile idiopathic arthritis - synovectomy - arthroscopic synovectomy

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